Metabolic Disease



A good date to evaluate your Health & Wellness, and Metabolic Diseases care and treatment options is today , if you have been diagnosed or concerned about having Metabolic Disease... Metabolism is the process your body uses to get or make energy from the food you eat. Food is made up of proteins, carbohydrates and fats. Chemicals in your digestive system break the food parts down into sugars and acids, your body's fuel. Your body can use this fuel right away, or it can store the energy in your body tissues, such as your liver, muscles and body fat.

A metabolic disorder occurs when abnormal chemical reactions in your body disrupt this process. When this happens, you might have too much of some substances or too little of other ones that you need to stay healthy.

You can develop a metabolic disorder when some organs, such as your liver or pancreas, become diseased or do not function normally. Diabetes is an example.

Metabolism is the means by which the body derives energy and synthesizes the other molecules it needs from the fats, carbohydrates and proteins we eat as food, by enzymatic reactions helped by minerals and vitamins.

This global statement masks the complicated network of enzyme - catalyzed reactions that occurs in cells. Although this page is devoted to diseases caused by errors in metabolic processes, there is actually a significant level of tolerance of errors in the system: often, a mutation in one enzyme does not mean that the individual will suffer from a disease. A number of different enzymes may compete to modify the same molecule, and there may be more than one way to achieve the same end result for a variety of metabolic intermediates. Disease will only occur if a critical enzyme is disabled, or if a control mechanism for a metabolic pathway is affected.

Below are highlighted the diseases of metabolism for which a gene has been identified, cloned and mapped. Many of these are inborn errors of metabolism:

metabolism inherited traits that are due to a mutation in a metabolic enzyme;

metabolism others involve mutations in regulatory proteins and in transport mechanisms.

Diseases

  • Adrenoleukodystrophy
  • Diabetes, type 1
  • Gaucher disease
  • Glucose galactose malabsorption
  • Hereditary hemochromatosis
  • Lesch-Nyhan syndrome
  • Maple syrup urine disease
  • Menkes syndrome
  • Niemann-Pick disease
  • Obesity
  • Pancreatic cancer
  • Phenylketonuria
  • Prader-Willi syndrome
  • Porphyria
  • Refsum disease
  • Tangier disease
  • Tay-Sachs disease
  • Wilson's disease
  • Zellweger syndrome

What Is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity. These risk factors increase your chance of having heart disease and other health problems, such as diabetes and stroke.

The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of getting a disease.

In this article, "heart disease" refers to coronary heart disease (CHD). CHD is a condition in which a fatty substance called plaque (plak) builds up inside the coronary (heart) arteries. Plaque narrows the arteries and reduces blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.



Metabolic Risk Factors

The five conditions described below are metabolic risk factors. You can develop any one of these risk factors by itself, but they tend to occur together. Metabolic syndrome is diagnosed if you have at least three of these metabolic risk factors.

  • A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the abdominal area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A higher than normal triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
  • A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL is sometimes called "good" cholesterol because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk of heart disease.
  • Higher than normal blood pressure (or you're on medicine to treat high blood pressure ). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps out blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
  • Higher than normal fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Overview of Metabolic Syndrome

Your risk of heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn't have metabolic syndrome.

Other risk factors, besides those described above, also increase your risk of heart disease. For example, a high LDL cholesterol level and smoking are major risk factors for heart disease, but they aren't part of metabolic syndrome.

Even having a single risk factor raises your risk of heart disease. You should try to control every risk factor you can to reduce your risk.

The chance of developing metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity . Insulin resistance also may increase your risk of metabolic syndrome.

Insulin resistance is a condition in which the body can't use its insulin properly. Insulin is a hormone the body uses to help change glucose (sugar) into energy. Insulin resistance can lead to high blood sugar levels, and it's closely linked to overweight and obesity.

Genetics (ethnicity and family history) and older age are other important underlying causes of metabolic syndrome.


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Outlook for Metabolic Syndrome

About 47 million adults in the United States (almost 25 percent) have metabolic syndrome, and the number continues to grow.

The increasing number of people who have this condition is linked to the rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

It's possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome takes a long-term effort and teamwork with your health care providers.

Other Names for Metabolic Syndrome

  • Dysmetabolic syndrome
  • Hypertriglyceridemic waist
  • Insulin resistance syndrome
  • Obesity syndrome
  • Syndrome X

What Causes Metabolic Syndrome?

Metabolic syndrome has several causes that act together. You can control some of the causes, such as overweight and obesity , an inactive lifestyle, and insulin resistance.

Other causes can't be controlled, such as growing older. Your risk of metabolic syndrome increases with age. You also can't control genetics, which may play a role in causing metabolic syndrome. For example, genetics can increase your risk of insulin resistance, which can lead to metabolic syndrome.

People who have metabolic syndrome often have two other conditions: excessive blood clotting and constant, low-grade inflammation throughout the body. It's not known whether these conditions cause metabolic syndrome or worsen it.

Researchers continue to study conditions that may play a role in metabolic syndrome, such as:

  • A fatty liver (excess triglycerides and other fats in the liver)
  • Polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)
  • Gallstones
  • Breathing problems during sleep (such as sleep apnea )

Who Is At Risk for Metabolic Syndrome?

People at greatest risk for metabolic syndrome have these underlying causes:

  • Abdominal obesity (a large waistline)
  • An inactive lifestyle
  • Insulin resistance

Some people are at risk for metabolic syndrome because the medicines they take may cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels.

These medicines most often are used for inflammation, allergies, HIV, and depression and other types of mental illnesses.

Populations Affected by of Metabolic Syndrome

About 47 million adults in the United States (almost 25 percent) have metabolic syndrome. The condition is more common in African American women and Mexican American women than in men of the same racial groups. Metabolic syndrome affects White women and men roughly equally.

Some racial and ethnic groups in the United States are at higher risk of metabolic syndrome than others. Mexican Americans have the highest rate of metabolic syndrome, followed by Whites and African Americans.

Other groups at increased risk for metabolic syndrome include:

  • People who have a sibling or parent who has diabetes
  • People who have a personal history of diabetes
  • Women who have a personal history of polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)

In addition, certain ethnic groups, such as South Asians, are at increased risk for metabolic syndrome.

Heart Disease Risk

Having metabolic syndrome increases your risk of heart disease. Go-Here to Search Health and Wellness Online Resources about Health Related Subjects of Interest Heart disease risk can be divided into short-term risk (the risk of having a heart attack or dying of heart disease in the next 10 years) and long-term risk (the risk of developing heart disease over your lifetime).

Other risk factors, besides metabolic syndrome, also increase your risk of heart disease. For example, a high LDL cholesterol level and smoking are major risk factors for heart disease. For detailed information about all of the risk factors for heart disease, go to the Diseases and Conditions Index Heart Disease Risk Factors article.

Even if you don't have metabolic syndrome, you should find out your short-term risk of heart disease. The National Cholesterol Education Program (NCEP) divides short-term heart disease risk into four categories, as shown below. Your risk category depends on which risk factors you have and how many you have.

Your risk factors are used to calculate your 10-year risk of developing heart disease. The NCEP has an online calculator that you can use to determine your 10-year heart disease risk score.

  • High risk: You're in this category if you already have heart disease or diabetes, or if your 10-year risk score is more than 20 percent.
  • Moderately high risk: You're in this category if you have two or more risk factors and your 10-year risk score is 10–20 percent.
  • Moderate risk: You're in this category if you have two or more risk factors and your 10-year risk score is less than 10 percent.
  • Lower risk: You're in this category if you have zero or one risk factor.

Even if your 10-year risk score isn't high, over time metabolic syndrome will increase your risk of heart disease. This means that, regardless of your short-term risk category, metabolic syndrome should be treated (mainly with lifestyle changes).



What Are the Signs and Symptoms of Metabolic Syndrome?

Metabolic syndrome is a group of risk factors that can raise your risk of heart disease and other health problems, even if they're only moderately raised (borderline-high risk factors).

Most of the metabolic risk factors have no signs or symptoms, although a large waistline is a visible sign.

Some people may have symptoms of high blood sugar (if diabetes, especially type 2 diabetes, is present). Symptoms of high blood sugar often include increased thirst; increased urination, especially at night; fatigue (tiredness); and blurred vision.

High blood pressure usually has no signs or symptoms. However, some people in the early stages of high blood pressure may have dull headaches, dizzy spells, or more nosebleeds than usual.

How Is Metabolic Syndrome Diagnosed?

Your doctor will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the five metabolic risk factors to be diagnosed with metabolic syndrome.

Metabolic Risk Factors

A Large Waistline

Having a large waistline means that you carry excess weight around your waist (abdominal obesity). This also is called having an "apple-shaped" figure. Your doctor will measure your waist to determine whether you have a large waistline.

A waist measurement of 35 inches or more for women and 40 inches or more for men is a metabolic risk factor and indicates an increased risk of heart disease and other health problems.

A Higher Than Normal Triglyceride Level

Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor. (The mg/dL is milligrams per deciliter—the units used to measure triglycerides, cholesterol, and blood sugar.)

A Lower Than Normal HDL Cholesterol Level

HDL cholesterol is sometimes called "good" cholesterol. This is because it helps remove cholesterol from your arteries.

An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic risk factor.

Higher Than Normal Blood Pressure

A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

If only one of your two blood pressure numbers is high, it's still a risk factor for metabolic syndrome.

Higher Than Normal Fasting Blood Sugar

A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100 and 125 mg/dL is considered pre diabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes.

A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is a metabolic risk factor.

About 85 percent of people who have type 2 diabetes—the most common type of diabetes—also have metabolic syndrome. These people have a much higher risk of heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome.

How Is Metabolic Syndrome Treated?

Healthy lifestyle changes are the first line of treatment for metabolic syndrome. Lifestyle changes include losing weight, doing physical activity regularly, following a heart healthy diet, and quitting smoking.

If lifestyle changes aren't enough, your doctor may prescribe medicines. Medicines are used to treat and control risk factors such as high blood pressure, high triglycerides, low HDL cholesterol, and high blood sugar.

Blood-thinning medicines, such as aspirin, also may be used to reduce the risk of blood clots. Excessive blood clotting is a condition that often occurs with metabolic syndrome.

Goals of Treatment

The major goal of treating metabolic syndrome is to reduce the risk of heart disease. Treatment is directed first at lowering LDL cholesterol and high blood pressure and managing diabetes (if these conditions are present).

The second goal of treatment is to prevent the onset of type 2 diabetes (if it hasn't already developed). Long-term complications of diabetes often include heart and kidney disease, vision loss, and foot or leg amputation.

If diabetes is present, the goal of treatment is to reduce the increased risk of heart disease by controlling all of your risk factors.

The main focus of treating metabolic syndrome is managing the risk factors that are within your control, such as overweight or obesity, an inactive lifestyle, and an unhealthy diet.

Lifestyle Changes

Losing Weight

In general, people who have metabolic syndrome and are overweight or obese should try to reduce their weight by 7–10 percent during the first year of treatment. For example, if you weigh 250 pounds, you should try to lose 18 to 25 pounds. If you weigh 300 pounds, you should try to lose 21 to 30 pounds.

After the first year, you're urged to continue to lose weight to the extent possible, with a long-range target of lowering your body mass index (BMI) to less than 25. BMI measures your weight in relation to your height and gives an estimate of your total body fat.

A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for prevention and treatment of metabolic syndrome.

You can calculate your BMI using the National Heart, Lung, and Blood Institute's (NHLBI's) or your health care provider can calculate your BMI.

For more information on losing weight or maintaining your weight, see the Diseases and Conditions Index article on Overweight and Obesity.

Following a Heart Healthy Diet

A heart healthy diet is an important part of a healthy lifestyle. Choose a variety of fruits, vegetables, and grains; half of your grains should come from whole-grain products.

Choose foods that are low in saturated fat, trans fat, and cholesterol. Healthy choices include lean meats, poultry without skin, fish, beans, and fat-free or low-fat milk and milk products.

Try to limit foods that have a lot of sodium (salt). Too much salt can raise your risk of high blood pressure. Recent studies show that following the Dietary Approaches to Stop Hypertension (DASH) eating plan can lower blood pressure.

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Choose foods and beverages that are low in added sugar. If you drink alcoholic beverages, do so in moderation.

Aim for a healthy weight by staying within your daily calorie needs. Balance the calories you take in with the calories you use while doing physical activity.

For more information on following a heart healthy diet, see the NHLBI's Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," "Your Guide to Lowering Your Blood Pressure With DASH," and "Your Guide to Lowering Your Cholesterol With TLC." All of these resources provide general information about healthy eating.

Doing Physical Activity Regularly

Being physically active, along with following a healthy diet and not smoking, is one of the most important things you can do to keep your heart and lungs healthy.

Many Americans are not active enough. The good news is that even modest amounts of physical activity are good for your health. The more active you are, the more you'll benefit.

Before starting any kind of exercise program or new physical activity, talk with your doctor about the types and amounts of physical activity that are safe for you.

The four main types of physical activity are aerobic, muscle-strengthening, bone strengthening, and stretching. You can do physical activity with light, moderate, or vigorous intensity.

The level of intensity depends on how hard you have to work to do the activity. People who have metabolic syndrome usually are urged to keep up a moderate level of activity.

For more information about physical activity, see the U.S. Department of Health and Human Services "2008 Physical Activity Guidelines for Americans," the Diseases and Conditions Index Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."

Smoking

If you smoke, quit. Smoking can raise your risk of heart disease and heart attack and worsen other heart disease risk factors. Talk to your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

Medicines

If lifestyle changes aren't enough, your doctor may prescribe medicines to help you control your risk factors. Medicines may be prescribed to help treat unhealthy cholesterol levels, high blood pressure, and high blood sugar.

Unhealthy cholesterol levels are treated with medicines such as statins, fibrates, or nicotinic acid. High blood pressure is treated with medicines such as diuretics or ACE inhibitors. High blood sugar is treated with oral medicines (such as metformin), insulin injections, or both.

Low-dose aspirin can help reduce the risk of blood clots, especially for people at high risk of heart disease. Click-here for Health Tip-of-the-Day.

How Can Metabolic Syndrome Be Prevented?

Making healthy lifestyle choices is the best way to prevent metabolic syndrome. One important lifestyle choice is to maintain a healthy weight. Other than weighing yourself on a scale, there are two ways to know whether you're at a healthy weight: waist measurement and body mass index (BMI).

A waist measurement indicates your abdominal fat and is linked to your risk of heart disease and other diseases. To measure your waist, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out. Make sure the tape is snug but doesn't squeeze the flesh.

A waist measurement of less than 35 inches for women and less than 40 inches for men is the goal for preventing metabolic syndrome; it's also the goal when treating metabolic syndrome.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for preventing metabolic syndrome; it's also the goal when treating metabolic syndrome.

You can calculate your BMI using the National Heart, Lung, and Blood Institute's or your health care provider can calculate your BMI.

To maintain a healthy weight, follow a healthy diet and try not to overeat. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.

Doing physical activity regularly also can help you maintain a healthy weight. Before starting any kind of exercise program or new physical activity, talk with your doctor about the types and amounts of physical activity that are safe for you.

Make sure to schedule regular doctor visits to keep track of your cholesterol, blood pressure, and blood sugar levels. A blood test called a lipoprotein panel will show your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.

Living With Metabolic Syndrome

Metabolic syndrome is a lifelong condition. However, lifestyle changes can help you control your risk factors and reduce your risk of heart disease and diabetes.

If you already have heart disease and/or diabetes, lifestyle changes can help you prevent or delay complications such as heart attack, stroke, and diabetes-related problems (for example, damage to your eyes, nerves, kidneys, feet, and legs).

Lifestyle changes may include losing weight, following a heart healthy diet, doing physical activity regularly, and quitting smoking.

If lifestyle changes aren't enough, your doctor may recommend medicines. It's important to take all of your medicines as your doctor prescribes. For more information about lifestyle changes and medicines, go to "How Is Metabolic Syndrome Treated?"

Make realistic short- and long-term goals for yourself when you begin to make healthy lifestyle changes. Work closely with your doctor and seek regular medical care.

Key Points of Metabolic Syndrome

  • Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity. These risk factors increase your risk of heart disease and other health problems, such as diabetes and stroke.
  • Metabolic syndrome is diagnosed if you have at least three of the five metabolic risk factors. These risk factors are:
    • A large waistline (abdominal obesity)
    • A higher than normal triglyceride level (or you're on medicine to treat high triglycerides)
    • A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol)
    • Higher than normal blood pressure (or you're on medicine to treat high blood pressure)
    • Higher than normal fasting blood sugar (or you're on medicine to treat high blood sugar)
  • Your risk of heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have.
  • The chance of developing metabolic syndrome is closely linked to overweight and obesity and lack of physical activity. Insulin resistance also may increase your risk of metabolic syndrome.
  • Genetics (ethnicity and family history) and older age are other important underlying causes of metabolic syndrome.
  • Most of the metabolic risk factors have no signs or symptoms, although a large waistline is a visible sign. Some people may have symptoms of high blood sugar or, occasionally, high blood pressure.
  • Symptoms of high blood sugar often include increased thirst; increased urination, especially at night; fatigue (tiredness); and blurred vision. Some people in the early stages of high blood pressure may have dull headaches, dizzy spells, or more nosebleeds than usual.
  • Your doctor will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the five metabolic risk factors to be diagnosed with the condition.
  • Healthy lifestyle changes are the first line of treatment for metabolic syndrome. Lifestyle changes include losing weight, doing physical activity regularly, following a heart healthy diet, and quitting smoking. If lifestyle changes aren't enough, your doctor may prescribe medicines.
  • Making healthy lifestyle choices is the best way to prevent metabolic syndrome. Important lifestyle choices include maintaining a healthy weight, doing physical activity regularly, and getting ongoing care.
  • Metabolic syndrome is a lifelong condition. However, lifestyle changes can help you control your risk factors and reduce your risk of complications. Successfully controlling metabolic syndrome takes a long-term effort and teamwork with your health care providers.

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